Mechanical ventilation with positive end-expiratory pressure in critically ill patients: comparison of CW-Doppler ultrasound cardiac output monitoring (USCOM) and thermodilution (PiCCO).

摘要: Background Aggressive mechanical ventilation can markedly and unpredictably aff ect cardiac function. The fall in output (CO) is due to a reduction left ventricular stroke volume (SV). aim of the present pilot study was assess eff ects diff erent positive end-expiratory pressure (PEEP) levels on circulatory function compare them with continuous wave (CW)-Doppler ultrasound monitoring (USCOM) thermodilution-based haemodynamic system (PiCCO).Methods Twenty mechanically ventilated (PEEP ≤10 mbar) adult patients (female n = 6, male 14, mean age 62 years, SAPS II-score 48.5), majority pneumonia septic shock) were followed USCOM PiCCO at stepwise increased PEEP-levels from 0-10 mbar (1 steps). changes CO/SV recorded.Results With both methods, an increase PEEP resulted decrease SV CO. Although absolute consistently higher by USCOM, parameters qual...